The Call-On-Doc Guide to Migraines

Migraine symptoms can vary from person to person and even from attack to attack. Common symptoms include:

• Throbbing or pulsing head pain (often one-sided)

• Nausea or vomiting

• Sensitivity to light, sound, or smells

• Visual disturbances (flashing lights, zigzag lines)

• Dizziness or brain fog

• Neck stiffness

• Fatigue before or after the headache

Some people experience migraine with aura, which includes temporary neurologic symptoms before the headache begins.

Not everyone experiences all phases, but migraines often follow a predictable pattern:

1. Prodrome – Mood changes, food cravings, fatigue, or neck stiffness (hours to days before)

2. Aura – Visual or sensory changes lasting 5–60 minutes

3. Attack – Head pain and associated symptoms lasting 4–72 hours

4. Postdrome – “Migraine hangover” with fatigue and difficulty concentrating

Migraine triggers are highly individual, but common ones include:

• Hormonal changes (especially estrogen fluctuations)

• Stress or emotional letdown

• Poor or irregular sleep

• Skipped meals or dehydration

• Certain foods (aged cheeses, processed meats, alcohol)

• Caffeine overuse or withdrawal

• Bright lights or strong smells

• Weather or barometric pressure changes

Identifying personal triggers can significantly reduce attack frequency.

• There is no single test for migraines. Diagnosis is based on:

• Symptom history and headache pattern

• Duration and severity of attacks

• Associated neurologic symptoms

• Ruling out secondary causes when red flags are present

• Most migraines can be safely diagnosed through a telehealth visit when symptoms are consistent and stable.

Treatment depends on attack frequency, severity, and individual response.

Acute (Abortive) Treatments

Used at the first sign of a migraine:

• Triptans

• NSAIDs

• Anti-nausea medications

• Combination migraine medications

Preventive Treatments

Recommended for frequent or disabling migraines:

• Beta blockers

• Antidepressants

• Anti-seizure medications

• CGRP inhibitors (newer migraine-specific therapies)

Lifestyle strategies such as hydration, sleep consistency, trigger management, and stress reduction also play a key role.

Seek urgent care if a headache is:

• Sudden and severe (“worst headache of your life”)

• Associated with fever, confusion, weakness, or vision loss

• New after age 50

• Triggered by head injury

• Progressively worsening over time

For recurring migraines, early treatment and prevention can dramatically improve quality of life.

If migraines are disrupting your daily life, Call-On-Doc makes it easy to get care without long waits.

You can:

• Discuss symptoms with a licensed provider

• Receive appropriate migraine medications when indicated

• Get guidance on prevention and trigger management

• Access care from home, often within minutes

Healthcare that fits your life — not your calendar.